What Happens When a Chiropodist or Podiatrist Leaves a Foot Care Clinic in Ontario?

Jun 20, 2024

10 min read

When a chiropodist or podiatrist leaves a foot care clinic, the departure involves much more than choosing a last day. The clinic and the departing practitioner may need to address notice, patient care, health records, privacy, billing, restrictive covenants, unfinished orthotic orders, professional liability coverage and regulatory reporting.

A poorly managed departure can interrupt patient care, expose personal health information, delay payments and lead to disputes about records or patient communications. A written transition plan can reduce those risks and help both sides meet their contractual and professional obligations.

This article explains the principal legal issues that Ontario foot care clinics, chiropodists and podiatrists should consider when a practitioner resigns, is terminated or otherwise stops providing services at a clinic.

Start With the Written Agreement

The first step is to review every agreement governing the relationship. This may include an employment agreement, independent contractor agreement, associate agreement, shareholder agreement, lease or space-sharing agreement, privacy agreement and any amendments.

The documents may address:

how much notice either party must provide;
whether the clinic may end the relationship immediately in specified circumstances;
compensation during the notice period;
outstanding accounts and post-departure collections;
access to patient and financial records;
patient notification procedures;
restrictive covenants and confidentiality obligations;
the return of clinic property;
responsibility for incomplete treatments, laboratory work and refunds; and
dispute resolution.

The agreement should be reviewed before either party sends a termination notice or communicates with patients. An impulsive email, immediate lockout or premature patient announcement can create avoidable legal and operational problems.

Is the Practitioner an Employee or an Independent Contractor?

The practitioner’s legal status affects the rights and obligations that may apply at departure. A contract may call someone an independent contractor, but that label is not conclusive. The actual relationship, including control, financial risk, ownership of tools, ability to work elsewhere and integration into the clinic, may also matter.

If the practitioner is an employee, Ontario’s employment standards legislation and potentially common law notice obligations may apply. The clinic should assess termination notice, termination pay, benefits continuation, vacation pay and, where applicable, severance pay before ending the relationship.

If the practitioner is genuinely an independent contractor, the written contract will often be central. However, a contractor may still argue that the relationship was improperly classified or that the contract required additional notice. The correct analysis depends on the facts, not only the agreement’s title.

Notice Should Be Clear and Documented

A departure notice should ordinarily identify the effective date, applicable contractual provision, expectations during the transition and arrangements for clinic property, records, billing and patient care.

For a resignation, the practitioner should confirm whether the agreement requires a particular notice period and whether the clinic can reduce clinical duties during that period. For a termination, the clinic should consider whether access restrictions are necessary and whether cutting off access immediately could interfere with continuity of care or record-keeping duties.

Not every departure should be handled in the same way. A planned retirement may allow an extended transition. A resignation to join another clinic may require careful communications and data controls. A termination involving alleged misconduct may require immediate safeguards, legal advice and consideration of mandatory reporting obligations.

Patient Care Must Remain the Priority

The College of Chiropodists of Ontario’s standards apply to registrants regardless of their role, job description or area of practice. A clinic contract does not eliminate a practitioner’s professional duties.

When services are discontinued, the College’s Records Standard requires a registrant to take reasonable steps to give appropriate notice to each patient for whom the registrant has primary responsibility. The registrant must also ensure that patient health and financial records are transferred to a successor or another registrant, securely retained, or securely disposed of subject to applicable retention requirements.

A transition plan should identify:

patients with upcoming appointments;
patients receiving an active course of treatment;
pending test results, referrals or follow-up care;
recent procedures requiring monitoring;
orthotics or other products ordered but not yet dispensed;
patients who may require urgent attention; and
which qualified practitioner will assume responsibility for each outstanding item.

The departing practitioner and clinic should document the handover. Simply cancelling appointments or assuming that another provider will review the charts may not be enough.

Who Keeps the Patient Records?

Disputes often arise because one side speaks of “owning” the charts. The more useful legal questions are who has custody or control of the personal health information, who is the health information custodian under Ontario’s Personal Health Information Protection Act, 2004, and what access each party requires to meet legal and professional duties.

The answer may depend on the clinic structure, the practitioner’s role, the information practices communicated to patients, the agreement and how records were created and maintained. A departing practitioner should not assume that they can download, email or remove an entire patient list or chart database. A clinic should not assume that it can permanently block access without considering the practitioner’s regulatory obligations.

The College’s Records Standard states that each registrant has an individual statutory responsibility for record keeping regardless of their employment circumstances or clinic arrangement. It also requires registrants to take reasonable steps to ensure required records are maintained.

The departure agreement or transition protocol should therefore address:

which party will retain the original record;
the departing practitioner’s continuing access for regulatory, insurance or legal purposes;
the process for responding to patient access and correction requests;
authorized transfers to a new provider;
retention periods and secure destruction;
responsibility for storage and retrieval costs; and
what happens if the clinic closes or changes ownership.

Under the College’s current Records Standard, patient records generally must be retained for at least 10 years following the patient’s last visit, with a different calculation where the patient was under 18 at the last visit, and at least seven years after a patient dies. The applicable rule should be confirmed for each record category and situation.

Protect Personal Health Information During Offboarding

Departures create a heightened privacy risk. The clinic should preserve information needed for patient care while promptly removing access that is no longer authorized.

A privacy-focused offboarding plan may include:

setting the time at which the practitioner’s electronic medical record access will change or end;
preserving appropriate access during an active notice or handover period;
disabling shared passwords and remote access;
retrieving clinic laptops, mobile devices, keys and security tokens;
confirming that personal devices do not contain unauthorized patient information;
reviewing audit logs for unusual access or bulk downloads;
redirecting clinic email and telephone communications appropriately;
documenting any permitted record copies or transfers; and
requiring prompt reporting of any suspected privacy breach.

PHIPA requires custodians to use reasonable safeguards against theft, loss and unauthorized use, disclosure, copying, modification or disposal. It also requires secure retention, transfer and disposal. A departing practitioner who acted as the clinic custodian’s agent may have had authority to access records for patient care while working at the clinic, but that authority does not automatically continue for unrelated purposes after departure.

Plan Patient Communications Carefully

Patients may need clear information about the practitioner’s last day, how ongoing care will be handled, how to obtain records and what options are available. The College’s discontinuation guidance emphasizes documenting the steps taken to inform patients of practical alternative care options.

The clinic and practitioner should agree, where possible, on:

who will prepare and send the notice;
which patients should receive it;
when it will be sent;
the wording and delivery method;
how patients can request a record transfer;
whether the practitioner’s new practice information may be included; and
how reception staff will answer questions consistently.

Communications should be factual and professional. They should not disparage either party, mislead patients about their options or use personal health information for an unauthorized marketing purpose.

Patient notification and patient solicitation are not necessarily the same thing. A neutral notice intended to protect continuity of care may be appropriate even where an agreement restricts solicitation. The exact wording and process should be reviewed in light of the contract, privacy obligations and professional duties.

Restrictive Covenants Require Individual Review

Associate and employment agreements may contain non-solicitation, non-competition, confidentiality and non-interference provisions. Their enforceability depends on their wording, the legal status of the practitioner, the surrounding facts and current Ontario law.

Ontario’s Employment Standards Act generally prohibits employers from entering into non-compete agreements with employees, subject to limited statutory exceptions. The legislation does not impose the same prohibition on non-solicitation or non-disclosure clauses, but those provisions still require separate legal analysis.

An independent contractor agreement may raise different issues. Courts scrutinize restrictive covenants, particularly where their language is ambiguous or broader than reasonably necessary to protect a legitimate business interest.

Neither side should assume that every restriction is enforceable or that none of them matter. Before contacting patients, referring sources, clinic employees or suppliers, the departing practitioner should obtain advice about the actual agreement. The clinic should also avoid threatening enforcement without first assessing the clause and the evidence.

Resolve Billing, Accounts and Financial Reconciliation

Financial disputes often surface after the clinical relationship has ended. The parties should establish a final reconciliation process covering:

services performed before the departure date but paid afterward;
insurer payments, reversals and audit adjustments;
refunds, credits and chargebacks;
outstanding patient balances;
laboratory, orthotic and supplier costs;
prepaid treatment packages or deposits;
vacation pay or other employee entitlements, where applicable;
holdbacks permitted by the agreement; and
the timing and supporting documents for the final statement.

The clinic should not withhold amounts merely because the relationship ended, unless the agreement and applicable law permit it. The practitioner should be able to verify the calculation using appropriate financial information without receiving unnecessary access to other patients’ personal information.

Deal With Orthotics, Devices and Unfinished Orders

Foot care practices often have clinical and financial obligations tied to custom orthotics, footwear, compression products, laboratory orders and other devices. The transition plan should identify every open order and assign responsibility for assessment, fitting, dispensing, follow-up, modification, refunds and supplier communication.

The clinic should avoid treating an unfinished order as only an accounting issue. The College’s requirements concerning custom foot orthotics include professional responsibilities related to assessment, dispensing and follow-up. If another registrant will complete the process, the handover should be clinically appropriate and clearly documented.

Return Property and Preserve Confidential Information

The departing practitioner may need to return keys, access cards, prescription materials, equipment, inventory, credit cards, computers and other clinic property. Both parties should also identify confidential business information such as fee schedules, supplier pricing, templates, policies, passwords, referral information and employee data.

The clinic should preserve relevant evidence if a dispute is anticipated, including the agreement, notices, billing statements, audit logs and communications. Neither party should alter patient charts to strengthen a contractual position. Corrections and late entries must comply with professional record-keeping requirements.

Consider Insurance and College Updates

The practitioner should confirm professional liability insurance requirements, including whether coverage must continue for claims made after departure. The clinic should verify its own coverage and any notice obligations to the insurer.

The practitioner may also need to update practice information with the College and ensure that public-facing information is accurate. If a professional corporation is involved, a change in practice or ownership may require additional corporate or College steps.

A Termination May Trigger Mandatory Reporting

Where a clinic terminates a chiropodist or podiatrist for reasons of professional misconduct, incompetence or incapacity, a report to the College may be legally required. The College states that employers must also report where a registrant resigns in lieu of termination for those reasons. The report is generally required as soon as possible and no later than 30 days after the employer becomes aware of the information.

Not every resignation or termination is reportable. A routine business separation is different from a termination based on professional misconduct, incompetence or incapacity. Because the consequences of reporting or failing to report can be significant, the clinic should assess this issue promptly and document its decision.

Practical Departure Checklist for Foot Care Clinics

Before the last day, the clinic and practitioner should consider completing the following steps:

Review all governing agreements and determine the practitioner’s legal status.
Confirm the notice period, final working day and transition duties in writing.
Identify active patients, upcoming appointments and incomplete care.
Assign responsibility for pending orthotics, laboratory work, referrals and follow-up.
Determine custody or control of records and document lawful post-departure access.
Prepare compliant patient communications and a record-transfer process.
Secure electronic systems, devices, keys and confidential information.
Reconcile billings, expenses, refunds, supplier charges and compensation.
Review restrictive covenants before patient or staff communications.
Confirm insurance, College updates and any mandatory reporting obligation.
Record the completed handover in a signed transition or departure document.

Can a Practitioner Take Their Patients to a New Clinic?

There is no universal answer. Patients make their own choices about where to receive care, but a practitioner’s ability to contact former patients or use clinic information may be affected by privacy law, the associate or employment agreement, and enforceable confidentiality or non-solicitation obligations.

A practitioner should not copy a patient list or access charts for marketing simply because they previously treated those patients. The clinic should also avoid obstructing appropriate patient choice, access to records or continuity of care. A carefully drafted notice and transfer process can separate legitimate care communications from commercial solicitation.

Can the Clinic Immediately Cut Off Record Access?

Immediate access restrictions may be appropriate where there is a credible privacy, security or patient-safety concern. In an ordinary departure, however, the clinic should consider whether the practitioner needs limited, supervised or time-bound access to complete charts, transfer care or meet professional obligations.

The solution may be a defined handover window, read-only access, audited access, copies supplied on request or a contractual process for later access. The right structure depends on who has custody or control of the records and why access is required.

Can the Clinic and Practitioner Sign a Departure Agreement?

Yes. A departure agreement can clarify the final date, compensation, release terms, patient notice, records, unfinished care, restrictive covenants, confidentiality, return of property and future cooperation. It is especially useful where the original agreement is incomplete or the relationship has become contentious.

Each party should receive independent legal advice where appropriate. A departure agreement should not purport to override PHIPA, the College’s standards, employment legislation or duties owed to patients.

Legal Support for Chiropodists and Podiatrists in Ontario

Delta Law assists Ontario chiropodists, podiatrists and foot care clinic owners with associate agreements, employment matters, practitioner departures, patient-record issues, privacy compliance, professional corporations and commercial contracts.

Learn more about our legal services for chiropodists and podiatrists.

This article provides general information and does not constitute legal advice. Legal advice depends on the facts of each situation.